Individual
STEPHEN M MBAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1822 METZEROTT RD APT 407, ADELPHI, MD 20783-5162
(240) 581-2620
Mailing address
1822 METZEROTT RD APT 407, ADELPHI, MD 20783-5162
(240) 581-2620
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN1005610
DC
374U00000X
Home Health Aide
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036061400
—
DC
Enumeration date
09/18/2012
Last updated
02/27/2024
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